Monday, December 9, 2013

Are you an ambulance driver or a paramedic? - By Shane E. Taylor

In my twenty three years as an Emergency Medical Services (EMS) provider, people have called me many things. Some make me feel good about myself like hero, guardian angel, lifesaver. Some refer to me as crazy, warped, weird…all true. Still others, (usually those who indulge in a little too much wine, whiskey or w..…hatever else), use more colorful language that isn’t fit to print in order to convey their utter contempt for me and my crew, often as we race to preserve their health and dignity. I’ve grown a pretty thick skin over the years, but there is still one name when uttered that causes my left eye to flutter and my upper right lip to twitch involuntarily – ambulance driver. 
Indeed, I do drive an ambulance, but I am a paramedic. Once-upon-a-time ago I was a basic Emergency Medical Technician, (now simply referred to as EMT). In between these two levels, I spent some time as an EMT-Intermediate (now called Advanced EMT). Never, ever have I been an ambulance driver. What’s that you say? What is the difference? I am so glad you asked!

First, I want to go on record that there is such a thing as an ambulance driver. There are many ambulance services in the State of Maine that employ individuals who want to be involved in the community, have an interest in public safety, but do not wish to become an EMT. These dedicated folks are ambulance operators that do not provide medical care to patients. They are commonly referred to as “ambulance drivers” and they are vital to the operations of many ambulance services. 

The Town of Windham is very fortunate to have an excellent team of caring and highly skilled EMTs, advanced EMTs and paramedics with the fire and rescue department. Their commitment to public service, public safety and emergency medicine is demonstrated in their ongoing educational efforts.

An EMT is a provider who is practicing a defined scope of practice in the entry level of EMS. This is NOT to say that they are all new or inexperienced, as there are many very talented providers out there who choose to remain at the EMT level and excel. An EMT has been educated in a number of emergency procedures, skills and knowledge. EMTs spend over 115 hours in the classroom and 16 hours in clinical settings on ambulances and emergency rooms. EMTs learn CPR and AED operation, trauma care, oxygen administration and many other skill sets that are critical to medical emergency response. Once licensed, an EMT continues their education for the rest of their EMS career by training regularly and learning from experiences, always changing and improving with the times.

Quite often, an EMT will come to a point where they want to advance to the next highest license level, advanced EMT. This requires more education that amounts to another 140 hours of classroom study and 150 hours of clinical time on top of what was required for entry level EMT. Students do clinical time on ambulances, in emergency rooms and spend some time in an operating room and critical care units. The licensed advanced EMT will have learned cardiac rhythm interpretation, Intravenous (IV) therapy, advanced trauma life support and will have the ability to administer several lifesaving medications. Like the EMT, A-EMTs continuously train and study to keep current with changes in medicine. 

Whether advancing through the ranks one license level at a time, or leaping directly into it from EMT status, paramedic school is a huge undertaking that rivals most any yearlong college experience and in some cases two years resulting in an associate’s degree in paramedicine. At a minimum a Paramedic student will spend 340 hours learning in the classroom and over 400 hours in clinical settings being taught by other Paramedics, doctors and nurses. 

Paramedic students become proficient in pre- hospital trauma life support, advanced cardiac life support, pediatric and neonatal advanced life support and geriatric emergency medical services. Skill sets include advanced airway, chest decompression, cardiac pacing and pain control among many others. Paramedics can give medications for cardiac problems, diabetic problems, breathing problems and severe allergic reaction problems to mention just a few. Continuing education and skill adaptation are as essential to the paramedic as to any other level of EMS provider. 

While working together as a team in as many combinations of the three provider levels as you can imagine, lives are saved, health is preserved and injuries are controlled every day. Much of what we do with our knowledge and skill at the scene of an emergency rivals the lifesaving actions that would otherwise take place in an emergency room. 

We are not doctors and we are not nurses. We are your emergency medical team, and we are here for you when you need us. Be safe!

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